FEMA Form 519-0-1N Public Assistance Customer Satisfaction Survey (Internet

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Department of Homeland Security
Federal Emergency Management Agency
Public Assistance Customer Satisfaction Survey
OMB Control Number 1660-0107
Expiration Date: 08-31-2015
FEMA Form 519-0-1INT

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FEMA PUBLIC ASSISTANCE CUSTOMER SATISFACTION SURVEY
PAPERWORK BURDEN DISCLOSURE NOTICE

Public reporting burden for this data collection is estimated to average 20 minutes per response. The burden estimate
includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting this survey. You are not required to respond to this collection of information unless a valid
OMB control number is displayed. This collection of information is voluntary.
Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to:
Records Management Division, Information Collections Management, Department of Homeland Security, Federal
Emergency Management Agency
(Paperwork Reduction Project 1660-0107)
500 C Street SW
Washington, DC 20472
NOTE: Do not send your completed form to this address.
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PRIVACY ACT STATEMENT

AUTHORITY: Government Performance and Results Act (GPRA), 5 U.S.C. Ch. 3 as amended and the GPRA of 2010
(P.L. 111-352); Executive Order (EO) 12862, “Setting Customer Service Standards;” and its March 23, 1995
Memorandum addendum, “Improving Customer Service; Executive Order 13411 “Improving Assistance for Disaster
Victims;” ; Executive Order 13571 “Streamlining Service Delivery and Improving Customer Service;” and its June 13, 2011
Memorandum “Implementing Executive Order 13571 on Streamlining Service Delivery and Improving Customer Service.”
PRINCIPAL PURPOSE(S): DHS/FEMA collects this information to measure Public Assistance applicants’ customers
satisfaction with FEMA services.
ROUTINE USE(S): This information is used for the principal purpose(s) noted above and will not be shared outside of
DHS/FEMA, except as allowed under DHS/FEMA-009 - Hazard Mitigation Assistance, Public Assistance, and Disaster
Loan System of Records (Date, FR reference), or as required by law.
DISCLOSURE: The disclosure of information on this form is strictly voluntary and will assist FEMA is making
improvements to its Public Assistance program; failure to provide the information requested will not impact the provision of
FEMA Public Assistance to qualified entities.
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Please answer the following questions about your experience with the Federal Emergency Management Agency
(FEMA) Public Assistance Program. Please select the appropriate response to the following questions. Your
answers will help to improve FEMA's response in future disasters.
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GENERAL QUESTIONS
The following questions ask for general information about your background.

1. What was the disaster type, declaration date, State involved, and disaster number of your most recent disaster where
FEMA provided assistance?

Type (flood, tornado, etc.)
xxxxx

Date declared (month/day/year)
xx/xx/xxxx

State involved
xx

Disaster number
xxxx

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The following questions may not pertain to all respondents. Please follow instructions associated
with the response chosen.
1. What is your organization type and your position?
State Grantee (NOTE: Select position then skip to question 4).
State Director
Governor's Authorized Representative (GAR)
Alternate GAR
Public Assistance Officer (PAO)
Deputy PAO
State Coordination Officer (SCO)

Assistant SCO
Other

Tribal
Subgrantee
Local government
State subgrantee
Special district
Private non-profit
Indian tribe/tribal organization/native village
Other
2. For what type(s) of projects(s) did you apply for?
Not applicable, state grantee (skip to question 4)
All large projects (over $XX in FY 20XX) (After responding, skip to question 4)
All small projects ($XX and under)
More large than small projects
More small then large projects
Equal number of large and small projects

3. If you applied for all large projects, please mark "not applicable" and go to question 5. Applicants have the option of
writing their own Project Worksheet(s) for small projects. For the small projects for which you applied, did you choose to
write your own Project Worksheet(s):
All of the time
Most of the time
Half of the time
Some of the time
Never
Not applicable, did not apply for small projects
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PROGRAM RESULTS
Please select the response that best describes your satisfaction level:
4. Overall, how satisfied are you with the Public Assistance PROGRAM?
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied (skip to 4a)
Dissatisfied (skip to 4a)
Very dissatisfied (skip to 4a)

4a. What specifically were you dissatisfied with?

5. Overall, how satisfied are you with the Public Assistance PROCESS?
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied (skip to 5a)
Dissatisfied (skip to 5a)
Very dissatisfied (skip to 5a)
5a. What specifically were you dissatisfied with?

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INFORMATION
The following questions pertain to your initial contact with FEMA.
6. How satisfied were you with the published information FEMA provided on the Public Assistance Program (e.g.,
documents on FEMA's website, documents received at the Kickoff Meeting, etc.)?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
7. How satisfied were you with staff's communication of information?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Never dealt with staff

8. How satisfied were you with the information FEMA provided you concerning the availability of Public Assistance
mitigation funding?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Did not receive any information on mitigation
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PERSONAL INTERACTION AND CUSTOMER SERVICE
The following questions concern your interactions with staff.
9. The field staff understood the eligibility requirements:
All of the time
Most of the time
More than half of the time
Less than half of the time
Some of the time
Never

Do not know
10. The field staff that conducted the site visit(s) were competent and understood the types of damage they were
assessing:
All of the time
Most of the time
More than half of the time
Less than half of the time
Some of the time
Never
Do not know
Not applicable - No site visit(s) necessary because always wrote own Project Worksheet(s)
Not applicable - Site visit(s) not yet conducted
11. The field staff that conducted the site visit(s) understood the local conditions that could influence the rebuilding
process.
Strongly agree
Agree
Slightly agree
Slightly disagree
Disagree
Strongly disagree
Do not know

Not applicable - No site visit(s) necessary because always wrote own Project Worksheet(s)
Not applicable - Site visit(s) not yet conducted
12. How reliable were the decisions and information you received from staff?
Very reliable
Reliable
Slightly reliable
Slightly unreliable
Unreliable
Very unreliable
Do not know
13. Was staff turnover a problem?
Yes
No
Do not know
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Please select the response that best describes your satisfaction level:
14. Overall, how satisfied were you with the CUSTOMER SERVICE provided by staff?

Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
15. Overall, how satisfied were you with the responsiveness provided by staff?
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
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PROJECT WORKSHEET PROCESS
The following questions relate to the Project Worksheet process.
NOTE: Not all questions may apply to you. Some questions ask about very specific Project Worksheet
activities. (Please select not applicable where appropriate.)
16. Overall, how satisfied were you with the Project Worksheet process?

Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
17. Did you receive Public Assistance mitigation funding?
Yes, received funding (please go to 18b)
No, applied for but did not receive funding (After responding, please skip to question 19)
Do not know (After responding, please skip to question 19)
Not applicable - Did not apply for funding (After responding, please skip to question 19)
17a. If you answered "yes" to Question 18a, how satisfied were you with the amount of Public Assistance mitigation
funding you received?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know

18. If FEMA conducted a site visit, FEMA conducted the Project Worksheet site visit(s):
Too soon after the disaster
At the right time
Too late to be helpful
Do not know
Site visit(s) not yet conducted
Not applicable - No site visit(s) necessary because always wrote own Project Worksheet
19. If FEMA developed the scope(s) of work, how satisfied were you with their development?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
Not applicable - Always wrote own Project Worksheet(s)
20. If FEMA identified damage repair cost estimates, how satisfied were you with these estimates?
Very satisfied
Satisfied
Slightly satisfied

Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
Cost estimates not yet completed
Not applicable - Always wrote own Project Worksheet(s)
21. If you wrote your own Project Worksheet(s), how satisfied were you with completing your Project Worksheet(s) in
terms of its complexity, your time invested, and the availability of necessary information?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Not applicable - Did not write any Project Worksheet(s)
22. If you had any small projects, and you chose not to write your own Project Worksheet(s), please briefly explain why
you asked FEMA to write your Project Worksheet(s).

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PROGRAM RESULTS
The following questions pertain to the overall results of the Public Assistance Program.

23. How satisfied were you with FEMA's timeliness:
23a. Overall:
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
23b. In relation to providing information:
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied

Very dissatisfied
23c. In relation to making eligibility decisions:
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
23d. In relation to providing funds:
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
24. How reasonable were administrative requirements for the following?
24a. Overall program
Very reasonable

Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable
24b. Pre-disaster documentation
Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable
24c. Project Worksheet review
Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable
24d. Payment of claims

Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable
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ALTERNATIVE PROCEDURES
The next questions are related to Public Assistance Alternative Procedures which you may have elected to
use for permanent work and debris removal projects.

25. Were you offered the opportunity to participate in the Alternative Procedures?
Yes (skip to question 25a)
No (skip to question 32)
Don't know/Don't remember (skip to question 32)
25a. Did you decide to participate?
Yes (skip to question 26)

Started to but then opted out (skip to question 25b)
No (skip to question 25b)
Don't know/Don't remember (skip to question 32)
25b. What were your reason for not participating in the Public Assistance Alternative Procedures?

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Thinking about the program elements that influenced your decision to participate, would you say:
26a. The incentives were:
Very important
Important
Not very important
Not at all important
26b. How effective have the Alternative Procedures been in improving your recovery?
Very important

Important
Not very important
Not at all important
26c. What other factors influenced your decision to participate?

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The next questions relate to the impact of the Alternative Procedures on your current level of recovery.
27. How would you rate the Alternative Procedures on iimproving the speed of your recovery? Would you say:
Excellent
Good
Satisfactory
Below average (skip to question 27a)
Poor (skip to question 27a)
No opinion
Too early to determine

27a. What changes could FEMA make to this program to improve your speed of recovery?

28. How effective have the Alternative Procedures been in improving your recovery?
Excellent
Good
Satisfactory
Below average (skip to question 28a)
Poor (skip to question 28a)
No opinion
Too early to determine
28a. What changes could be made to improve the effectiveness?

29. How satisfied are you with the estimates used for your pilot program projects?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied (skip to question 29a)
Dissatisfied (skip to question 29a)
Very dissatisfied (skip to question 29a)
No opinion
Too early to determine

29a. What changes are needed to improve your satisfaction with the estimates?

30. If the independent expert panel was used on your projects, how satisfied are you with the panel process?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied (skip to question 30a)
Dissatisfied (skip to question 30a)
Very dissatisfied (skip to question 30a)
No opinion
Too early to determine
30a. What changes are needed to improve the panel process?

31. In the future, should you need to apply for a Public Assistance grant, how likely are you to use the Alternative
Procedures option?
Definitely use
Probably use

Might or might not use
Probably would not use
Definitely would not use
Don't know/No opinion
32. What additional recommendations do you have for improving the alternative procedures?

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Thinking about this disaster and Public Assistance overall
33. Is there anything you would have liked FEMA to have done differently during this disaster recovery?

34. Please provide any additional comments or suggestions regarding the Public Assistance Program.

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The Federal Emergency Management Agency (FEMA) Public Assistance Program appreciates your feedback!
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